B.TECH APPLICATION FORM 2023 (PHASE-3)
APPLICATION NO :23013024810
Program And Campus Preference
Campus
Preference 1
SRM IST DELHI NCR
CAMPUS, GHAZIABAD
(UP)
Program
Preference 1
COMPUTER SCIENCE
AND ENGINEERING
Specialization
Preference 1
COMPUTER SCIENCE
AND ENGINEERING
Campus
Preference 2
SRM IST DELHI NCR
CAMPUS, GHAZIABAD
(UP)
Program
Preference 2
COMPUTER SCIENCE
AND ENGINEERING
Specialization
Preference 2
ARTIFICIAL
INTELLIGENCE AND
MACHINE LEARNING
Campus
Preference 3
SRM IST DELHI NCR
CAMPUS, GHAZIABAD
(UP)
Program
Preference 3
COMPUTER SCIENCE
AND ENGINEERING
Specialization
Preference 3
CYBER SECURITY
Personal Details
Nationality
INDIAN
Have You Studied From India?
YES
Student Aadhar No.
Full Name (As Per The Qualifying Examination
Certificate)
UNNAT BHANSALI
Mobile No.
+91-8010714604
WhatsApp Mobile Number
+91-9193022552
Email ID
PRATEEKMAHESHWARI81@GMAIL.COM
Alternate Email ID
UNNATMAHESHWARI2@GMAIL.COM
Date Of Birth
08/02/2005
Gender
MALE
Family Details
Parent Details :FATHER
Father
Title
MR
Name
ALOK MAHESHWARI
Mobile Number
+91-9193022553
Email Address
ALOKMAHESHWARI11@YAHOOMAI
L.COM
Mother
Guardian
Address Details
Address
F660 KAMLANAGAR, AGRA
Pin Code :
282005
Country Name : INDIA
State : UTTAR PRADESH
District : AGRA
City: AGRA
Academic Details
Current Education Qualification Status : 12TH COMPLETED
XII Details :
X Details :
Institute Name
SUMEET RAHUL GOEL MEMORIAL, SCHOOL AGRA
BIRLA SCHOOL PILANI, JHUNJHUNU RAJASTHAN
Board
CENTRAL BOARD OF SECONDARY EDUCATION (CBSE)
CENTRAL BOARD OF SECONDARY EDUCATION (CBSE)
Mode of Study
REGULAR
REGULAR
Marking Scheme
PERCENTAGE
PERCENTAGE
Percentage / CGPA
79.4
89.1
Year Of Passing
2023
2021
Hall ticket No./Registration No.
21602195
A121104580033
Address Of School/College
KAMLA NAGAR, AGRA-282005
NAD ID/Digilocker ID
-
Payment Details
Transaction ID
112952850256
Payment Date
26/07/2023
Mode Of Payment
Declaration
I Certify That The Information Submitted By Me In Support Of This Application, Is True To The Best Of My Knowledge And Belief. I Understand
That In The Event Of Any Information Being Found False Or Incorrect, My Admission Is Liable To Be Rejected / Cancelled At Any Stage Of The
Program. I Undertake To Abide By The Disciplinary Rules And Regulations Of The Institute
Applicant Name : UNNAT BHANSALI
Parent Name : ALOK MAHESHWARI
Date : 26/07/2023